Health secretary Steve Barclay will hold crisis talks with ambulance unions on Tuesday over emergency strike cover, as nurses leaders warned that their members’ industrial action over pay could last six months.
Barclay will meet leaders of three unions representing ambulance workers to discuss what cover for 999 calls will be provided during action over pay on Wednesday, while the NHS will be hit by a strike by nurses on Tuesday.
Some people with serious health conditions will be forced to call taxis rather than ambulances in order to go to hospital, although health chiefs expect that the most serious cases, including heart attacks, will be covered.
Rishi Sunak is contending with a wave of strikes across the UK as unions in the public sector and beyond respond to the cost of living crisis with demands for higher pay for their members.
The industrial action by NHS workers poses the biggest challenge to the prime minister, with opinion polls suggesting that the public is largely supportive of their strike action. Some Tory MPs believe that more money should be provided.
Sunak on Monday urged health unions to consider whether strikes were “really necessary” as he defended the government’s decision to adhere to NHS pay recommendations by an independent review body.
“I’m really disappointed to see that the unions are calling these strikes, particularly at Christmas, particularly when it has such an impact on people’s day-to-day lives,” he said.
The idea of a one-off payment to NHS workers has been discussed by government insiders but was quashed by Downing Street and the Treasury, according to people briefed on the deliberations, because it would have set a costly precedent.
Barclay has attempted to talk to unions about next year’s NHS pay round, which takes effect in April 2023, but the government is refusing to reopen this year’s settlement.
One government insider said the independent review body would take account of the very tight labour market and the need for pay to allow retention and recruitment of NHS workers — a hint of higher remuneration in future.
But union leaders want to discuss this year’s pay settlement. Christina McAnea, head of the Unison union that represents ambulance workers as well as other NHS staff, said: “At some point, the government is going to have to get into talks to resolve this.
“Ministers should do that now, avoid the strikes, and what looks like inevitable escalation in the new year.”
A senior official at the Royal College of Nursing, which organised the nurses’ strikes last Thursday in England, Wales and Northern Ireland and the action this week, suggested that it could last well into next year if the union could not reach an agreement on pay with the government.
Patricia Marquis, RCN England director, told Times Radio: “Sadly if there is no resolution, then our members have taken a vote to take strike action and the mandate lasts for six months.”
Talks between NHS ambulance trusts and union leaders continued on Monday over which services would be protected from strike action in England and Wales, with health leaders hoping for a broadly consistent approach across different areas.
People familiar with the discussions said they were coalescing around the idea of answering all category one calls — life-threatening emergencies — plus the most urgent category two calls.
The second category includes suspected strokes or chest pains. Conditions that fall outside these two categories include urgent but uncomplicated diabetes cases, and people who are not seriously ill but require medical treatment at hospital.
Under an agreement struck between South East Coast Ambulance Service and the GMB union, striking workers may be asked to respond to certain calls if others are unable to cover them, according to people briefed on the deal.
These calls would include going to the aid of elderly people who have been on the floor for more than four hours after a fall, as well as stroke and cardiac incidents where treatment was time critical.
Among Conservative MPs there was a sense of foreboding over how long the stalemate between the government and unions over NHS pay can last.
“It wouldn’t surprise me if the chaos in the NHS reaches fever pitch and the government ends up having to climb down,” said one former minister.
Meanwhile, travel disruption will spread to airports when Border Force immigration officials begin eight days of strikes on Friday.
There will also be more disruption on the railways when industrial action organised by the RMT union resumes on December 24.
Additional reporting by Philip Georgiadis